Is Bonjela Safe to Use in Children?
Bonjela has often been recommended for soothing irritated gums in infants who are teething. Recently, a health warning issued in Australia advised against the use of Bonjela in children under 16 years old because one of its active ingredients - salicylate - was believed to be a potential cause of Reye's Syndrome. The initial warning came from the UK after three children who had been treated with Bonjela were suspected to have Reye's Syndrome.
All three children made a full recovery and though Reye's Syndrome had not been confirmed in any of them, the advice against the use of Bonjela in under 16 year olds remains. The sentiments being that since there are other alternatives available, there is no sense in taking unnecessary risks.
The advice is against the use of the products Bonjela and Bonjela Cool Mint Gel (the latter isn't sold here). Bonjela Teething Gel, however, has been given the all clear for continued use in children (although this isn't sold here either).
That raises another question. If salicylate in Bonjela is not recommended for use in children under 16 years of age, does this also apply to all other products contatining salicylate? Listerine mouthwash is one such product containing salicylate as an active ingredient. There hasn't been any warnings issued on these other products - why not? Or don't they apply?
A recent article from New Zealand, however, has declared Bonjela safe for use after the Medsafe group had reviewed all the data and were satisfied with the safety of the product. The concerned they raised was the possibility of unintentional overdose as the New Zealand Poisons Centre data revealed an overuse of the product. They urged users to stick to the recommended dosage.
There's a good Q&An article on this topic located here.
Personally, I'm inclined to agree with Medsafe. A 30 year history of usage in children for teething purposes and no reported cases of Reye's Syndrome? I think that's a pretty good history. For most medical studies, a 10 year history is considered "long-term".
When it comes to topical creams and ointments, there is definitely a tendency of over applying and it is very easy to "exceed recommended dosages". In the mouth of a child, everything gets swallowed. When you consider how little their bodies are, it really isn't surprising that you can easily end up with an accidental overdose.
What are the alternatives besides Bonjela for teething? In some countries there is a specific formula called Bonjela for Teething. This is specifically designed for infants and is still safe for use. An alternative product is called Dentinox Teething gel. The active ingredient is lidocaine hydrochloride which is in a topical anaesthetic used in the dental clinic. The concentration in Dentinox Teething gel is a lot lower though - 0.33% as opposed to the 2% concentrations used in the clinic setting.